High-touch Areas Research Articles

The impact of enhanced cleaning on bacterial contamination of the hospital environmental surfaces: a clinical trial in critical care unit in an Egyptian hospital.

Contaminated environmental surfaces play an important role in the transmission of pathogens that cause healthcare acquired infection (HAI). The present study aimed to assess the effect of enhanced cleaning techniques on bacterial contamination in high-touch areas compared to routine cleaning at the intensive care units (ICU) of the neurosurgery department of Alexandria Main University Hospital, Egypt. The assessment of the knowledge and practices of healthcare cleaning workers and nurses was conducted through a questionnaire and an observational checklist. An educational program about enhanced cleaning was carried out for healthcare cleaning workers and nurses in one room of the ICU unit. Environmental surface swabs were taken from the two rooms of the ICU before and after cleaning (room A and room B). Room A was selected to apply the enhanced cleaning, and room B was selected for routine cleaning. A significant decrease in bacterial counts in the high-touch areas around the patients after the application of enhanced cleaning compared to routine cleaning (p < 0.001) was observed. Gram-negative bacteria isolated from high-touch areas accounted for 45.6% of the samples collected before enhanced cleaning, and they became 16.3% after enhanced cleaning (p < 0.001), while they accounted for 40% after routine cleaning. The enhanced cleaning intervention in Room A resulted in a significant reduction in total infections, decreasing from 18 cases in the six months prior to the intervention to 11 cases in the six months following its implementation. (p < 0.05). The effect of enhanced cleaning was evident in decreasing bacterial counts in the high-touch areas around the patient and consequently in the records of the HAI rate inside the ICU. PACTR202402531001186, date: 15 February 2024, 'retrospectively registered'.

Safely reopening and operating a primary healthcare facility after closure due to SARS-CoV-2 infection in a healthcare worker – Nairobi, Kenya, 2020

The first COVID-19 case in a healthcare worker in Kenya was reported on March 30, 2020, in Nairobi, leading to a 41-day closure of the health facility where he had worked. We assessed infection prevention and control (IPC) activities and implemented recommendations to re-open and operate the facility. We conducted a risk assessment of the facility in April 2020 using a modified World Health Organization, six-element IPC facility risk assessment tool. IPC recommendations were made, and a follow-up assessment of their implementation was conducted in July 2020. Breaches in IPC measures included poor ventilation in most service delivery areas; lack of physical distancing between patients; inadequate COVID-19 information, education, and communication materials; lack of standard operating procedures on cleaning and disinfecting high-touch areas; insufficient IPC training; inadequate hand hygiene facilities; insufficient personal protective equipment supplies; and an inactive IPC committee. Strengthening IPC measures is critical to prevent healthcare facility closures.

MICROBIOLOGICAL PROFILE OF HIGH TOUCH AREAS OF CRITICAL AND NON-CRITICAL UNITS IN TEACHING HOSPITAL OF MADHYA PRADESH, INDIA

In the current scenario, Nosocomial infections (NI) due to environmental contamination in shared settings of health care, are a serious public health issue affecting millions of people every year worldwide. Therefore, this study aims to create a microbiological profile of high touch areas of Critical and Non-Critical units in Teaching Hospital of Madhya Pradesh. This Cross-sectional Study deals with bacterial (aerobic and anaerobic) surveillance and its antimicrobial susceptibility testing which will aid in enlisting antimicrobial-resistant bacteria and guide us in the use of antimicrobials judiciously. A total of 128 samples were taken from Critical care units and non-Critical units from eight surface locations classified into categories of immediate patient environment and commonly used equipment. These samples were then processed for isolation and identification by standard methods. Out of 128 samples, 28 (21.8%) samples were culture positive for aerobic only and none for anaerobic bacteria. Among which more culture positive samples were isolated from non-Critical units 53.5%, topping the list of contamination were General Medicine ward and Gynecology ward (17.8 %). The majority of isolated microorganisms were Staphylococcus aureus of which 38.4% were MRSA. It showed maximum resistance for Ampicillin (AMP) and was most sensitive to Gentamicin (GEN). Present study highlights that control of Staphylococcus aureus infection (including MRSA) in hospitals is essential. It can be achieved by proper implementation of hospital infection control measures and regular surveillance activity.

Highly Effective Salt-Activated Alcohol-Based Disinfectants with Enhanced Antimicrobial Activity.

Surfaces contaminated with pathogens raise concerns about the increased risk of disease transmission and infection. To clean biocontaminated surfaces, alcohol-based disinfectants have been predominantly used for disinfecting high-touch areas in diverse settings. However, due to its limited antimicrobial activities and concern over the emergence of alcohol-tolerant strains, much effort has been made to develop highly efficient disinfectant formulations. In this study, we hypothesize that the addition of a physical pathogen inactivation mechanism by salt recrystallization (besides the existing chemical inactivation mechanism by alcohol in such formulations) can improve inactivation efficiency by preventing the emergence of alcohol tolerance. To this end, we employed the drying-induced salt recrystallization process to implement the concept of highly efficient alcohol-based disinfectant formulations. To identify the individual and combined effects of isopropyl alcohol (IPA) and NaCl, time-dependent morphological/structural changes of various IPA solutions containing NaCl have been characterized by optical microscopy/X-ray diffraction analysis. Their antimicrobial activities have been tested on surfaces (glass slide, polystyrene Petri dish, and stainless steel) contaminated with Gram-positive/negative bacteria (methicillin-resistant Staphylococcus aureus, Pseudomonas aeruginosa, and Salmonella enterica subsp. enterica Typhimurium) and viruses (A/PR8/34 H1N1 influenza virus and HCoV-OC43 human coronavirus). We found that additional salt crystallization during the drying of the alcohol solution facilitated stronger biocidal effects than IPA-only formulations, regardless of the types of solid surfaces and pathogens, including alcohol-tolerant strains adapted from wild-type Escherichia coli MG1655. Our findings can be useful in developing highly effective disinfectant formulations by minimizing the use of toxic antimicrobial substances to improve public health and safety.

SG-APSIC1154: Evaluation of disposable antimicrobial curtains in an ambulatory cancer center

Objectives: The prevention of nosocomial infection is a challenge for all healthcare institutions. Privacy curtains are often changed infrequently, and they are difficult to clean. Contaminated curtains can be touched by healthcare providers and patients, which may result in indirect transmission of infectious disease. Hence, we evaluated the impact of the antimicrobial properties of disposable curtains and their cost-effectiveness. Methods: This descriptive exploratory study was conducted in an ambulatory cancer center in 2017. Privacy curtains were assigned to 2 cohorts, labelled E1 and E2. They were placed in the clinical areas for 6–12 months. Moist swab samples for MRSA, VRE, and CP-CRE cultures were obtained from the leading edges of the curtains during the evaluation period. Also, 10-cm × 10-cm swatches were cut from the high-touch areas of curtains and were tested for total aerobic count on the first of the month and quarterly thereafter. Results: All bacterial culture swabs obtained from the E1 and E2 cohorts of curtains were negative. The total bacterial plate count results from E1 curtains were negative for up to 1 year. However, the total bacterial plate count results for E2 curtains were positive in the sixth month. Using disposable curtains yielded an annual cost saving of ~50%. Conclusions: The use of appropriate impregnated antimicrobial disposable curtains can improve patient safety in the clinical areas. These curtains may eliminate potential sources of infection and thereby decrease the rate of nosocomial infection. They also save significant institutional costs by reducing frequent laundry and manpower requirements needed for the installation of curtains.

Ultra Violet (UV) Light Irradiation Device for Hospital Disinfection

The biomedical technology application of ultraviolet light device was reviewed in the current research in a manner to improve public healthcare safety. The research adopted ultraviolet light irradiation to enable elimination of hospital acquired infections caused by bacteria, viruses, and other pathogens within the healthcare facilities. The paper reviewed 12 related biomedical literature that discussed the topic of hospital disinfection using ultraviolet device technology. The paper observed that installation of autonomous internet of things 5G medical disinfecting device for continuous sterilisation of high-touch areas is important in the ongoing COVID-19 pandemic. The research concluded that installation of autonomous internet of things 5G ultraviolet device within the hospital facilities will provide a means for infectious surveillance that will effectively control the menace of hospital acquired infections through ultraviolet light irradiation as the susceptibility of hospital acquired infections are exceedingly high in the overcrowded healthcare centres.

Air and surface sampling for monkeypox virus in a UK hospital: an observational study

BackgroundAn outbreak of monkeypox virus infections in non-endemic countries was recognised on May 12, 2022. As of September 29, more than 67 000 infections have been reported globally, with more than 3400 confirmed cases in the UK by September 26. Monkeypox virus is believed to be predominantly transmitted through direct contact with lesions or infected body fluids, with possible involvement of fomites and large respiratory droplets. A case of monkeypox in a health-care worker in the UK in 2018 was suspected to be due to virus exposure while changing bedding. We aimed to measure the extent of environmental contamination in the isolation rooms of patients with symptomatic monkeypox.MethodsWe investigated environmental contamination with monkeypox virus from infected patients admitted to isolation rooms at the Royal Free Hospital (London, UK) between May 24 and June 17, 2022. Surface swabs of high-touch areas in five isolation rooms, of the personal protective equipment (PPE) of health-care workers in doffing areas in three rooms, and from air samples collected before and during bedding changes in five rooms were analysed using quantitative PCR to assess monkeypox virus contamination levels. Virus isolation was performed to confirm presence of infectious virus in selected positive samples.FindingsWe identified widespread surface contamination (56 [93%] of 60 samples were positive) in occupied patient rooms (monkeypox DNA cycle threshold [Ct] values 24·7–37·4), on health-care worker PPE after use (Ct 26·1–35·6), and in PPE doffing areas (Ct 26·3–36·8). Of 20 air samples taken, five (25%) were positive. Three (75%) of four air samples collected before and during a bedding change in one patient's room were positive (Ct 32·7–36·2). Replication-competent virus was identified in two (50%) of four samples selected for viral isolation, including from air samples collected during bedding change.InterpretationThese data show contamination in isolation facilities and potential for suspension of monkeypox virus into the air during specific activities. PPE contamination was observed after clinical contact and changing of bedding. Contamination of hard surfaces in doffing areas supports the importance of cleaning protocols, PPE use, and doffing procedures.FundingNone.

Transfer of Extended Spectrum Cephalosporin Resistant Enterobacteriaceae Among Patients on an HSCT Unit and the Value of Surveillance and Contact Isolation

The mechanism(s) of acquisition of extended-spectrum cephalosporin-resistant Enterobacteriaceae (ESCRE) on inpatient hospital units dedicated to hematopoietic stem cell transplantation (HSCT) is unclear. The objectives of this study were to determine whether ESCRE organisms are transmitted among patients housed on a HSCT unit, clarify the mechanisms involved, and determine whether routine surveillance for ESCRE carriage and contact isolation for ESCRE carriers is beneficial. The study was conducted on a 30-bed inpatient unit dedicated to the care of patients with hematologic malignancies and HSCT recipients. To investigate whether ESCRE organisms may be transmitted vertically to subsequent room occupants, presumably through contamination of room surfaces, we (1) cultured 6 high touch areas in 10 rooms before and 9 rooms after terminal cleaning that had been occupied by patients with ESCRE carriage, (2) determined the in vitro survivals of our most common clinical ESCRE species, and (3) followed the subsequent room occupants of 54 consecutive ESCRE colonized patients for the development of inpatient acquired ESCRE carriage. To investigate whether ESCRE organisms are transmitted horizontally among inpatients we (1) sequenced 60 available ESCRE Escherichia coli isolates obtained from unit inpatients and searched for identities using complete-genome multisequence locus typing (cgMLST) and (2) retrospectively tabulated the cumulative rates of acquired ESCRE carriage in 356 patients admitted for a first HSCT before (200 patients) or after (156 patients) institution of universal ESCRE stool surveillance and contact isolation for carriers. No ESCRE organisms were cultured from patient rooms before or after terminal cleaning. In vitro, few, if any, ESCRE organisms survived longer than 2 hours. Nine of the subsequent occupants of a room in which a patient with ESCRE carriage had resided were detected with ESCRE carriage, only 2 of whom carried the same species as that of the prior occupant. DNA sequencing and cgMLST determination of the 60 E. coli isolates showed 53 cgMLST strains. Seven of the 53 strains were shared by 2 patients. After institution of universal ESCRE surveillance/isolation there was a significant decline in acquired ESCRE carriage among HSCT recipients. We conclude that vertical transmission of ESCRE organisms through room contamination appears to be uncommon on modern HSCT units. Conversely, our results are consistent with the horizontal spread of ESCRE organisms, probably mediated by intermediate vectors such as personnel or shared equipment. Further studies are needed to better define the magnitude of and risk factors for ESCRE horizontal transfers and the benefits of ESCRE surveillance/isolation.

Monkeypox virus contamination in an office-based workplace environment

Monkeypox virus contamination in an office-based workplace environment

Inactivation of MS2 bacteriophage on copper film deployed in high touch areas of a public transport system.

Although SARS-CoV-2 is primarily an airborne risk, the COVID-19 pandemic also highlighted the need for self-disinfection surfaces that could withstand the demand of high occupant densities characteristic of public transportation systems. The aim of this study was to evaluate the durability and antiviral activity of a copper film deployed for 90 days in two high touch locations within an active metropolitan bus and railcar. The antiviral efficacy of this copper film after being deployed in transit vehicles for 90 days (deployed copper film) was then compared to new (unused) copper film to determine if frequent touches and cleaning protocols could decrease the efficacy of the copper films. Deployed copper film, new copper film, and aluminium foil (positive control) coupons were inoculated with ~1 × 106 MS2 virus particles, allowed a contact time of either 5- or 10-min, and analysed for residual viral infectiousness. On both new and deployed copper films, MS2 was completely inactivated (≥5 log reduction) at both time points. These results suggest that the copper film may provide the durability demanded by high touch public spaces while maintaining the antiviral activity necessary to reduce exposure risk and viral transmission via surfaces in public transportation settings.

Optimal path planning of a disinfection mobile robot against COVID-19 in a ROS-based research platform

Due to COVID-19 pandemic, there is an increasing demand for mobile robots to substitute human in disinfection tasks. New generations of disinfection robots could be developed to navigate in high-risk, high-touch areas. Public spaces, such as airports, schools, malls, hospitals, workplaces and factories could benefit from robotic disinfection in terms of task accuracy, cost, and execution time. The aim of this work is to integrate and analyse the performance of Particle Swarm Optimization (PSO) algorithm, as global path planner, coupled with Dynamic Window Approach (DWA) for reactive collision avoidance using a ROS-based software prototyping tool. This paper introduces our solution – a SLAM (Simultaneous Localization and Mapping) and optimal path planning-based approach for performing autonomous indoor disinfection work. This ROS-based solution could be easily transferred to different hardware platforms to substitute human to conduct disinfection work in different real contaminated environments.

Essential Oil Disinfectant Efficacy Against SARS-CoV-2 Microbial Surrogates.

Reports of COVID-19 cases potentially attributed to fomite transmission led to the extensive use of various disinfectants to control viral spread. Alternative disinfectants, such as essential oils, have emerged as a potential antimicrobial. Four essential oil blends were tested on three different surfaces inoculated with a coronavirus surrogate, bacteriophage Phi 6, and a bacterial indicator, Staphylococcus aureus. Log10 concentration reductions were analyzed using GraphPad Prism software. Data collected in this study show that the application of dilute essential oil disinfectants using a spray delivery device is an effective way to reduce concentrations of bacterial and viral microorganisms on ceramic, stainless steel, and laminate surfaces. Surrogate viruses were reduced up to 6 log10 PFU and bacterial were reduced up to 4 log10 CFU. Although surfaces are no longer considered a high risk fomite for COVID-19 transmission, the disinfection of microorganisms on surfaces remains an important consideration for high touch areas in hospitals, waiting rooms, etc. The application of spray disinfectants, based on essential oil blends, provides a rapid and effective means to reduce microbial contamination on high-touched surfaces.

Effectiveness of ultraviolet-C vs aerosolized hydrogen peroxide in ICU terminal disinfection

According to the Centers for Disease Control and Prevention, 10% of patients with healthcare-acquired infections (HAIs) died during hospitalization in 2015. Thus, a reduction in the prevalence of HAIs is critical. One strategy to achieve this is the adequate disinfection of patient rooms within hospitals. To compare the effectiveness of an ultraviolet-C (UV-C) room sanitizer with an aerosolized hydrogen peroxide (aHP) device for the elimination of selected healthcare-associated (HA) pathogens and other HA organisms in an intensive care unit (ICU) setting. The disinfection systems were tested on the following organisms: meticillin-resistant Staphylococcus aureus, extended-spectrum beta-lactamase-producing Klebsiella pneumoniae, carbapenem-resistant K.pneumoniae, vancomycin-resistant enterococci, multi-drug-resistant Acinetobacter baumannii and Candida auris. Media plates with known densities of each organism were placed at preselected regions within an ICU room. The mean kill rate was determined for each organism. Additionally, swabs were taken from five high-touch areas from different ICU rooms prior to manual cleaning, following manual cleaning, and following each disinfection method in order to compare their effectiveness. The UV-C device achieved a 96.75% mean microbial reduction in non-shaded areas. It was significantly less effective in shaded areas. The aHP system achieved a mean kill rate of 50.71% for all areas. The swab results revealed that 15% of manually cleaned surfaces still harboured a microbial load, which was eradicated after use of either of the no-touch disinfection systems. This study found notable differences between two no-touch disinfection methods, highlights their effectiveness, and advocates for their incorporation alongside a manual cleaning regimen.

Environmental surface contamination with SARS-CoV-2 in professional football clubs

ABSTRACT Background: We assessed SARS-CoV-2 contamination of random surfaces in football training facilities in an environment with a high prevalence of infections. Methods: In six clubs of the Qatar Stars League, surfaces of random locations (high-touch areas, ventilation systems, toilets, cleaning tools, freezers, pantries) in routinely cleaned training facilities, locker rooms, medical and administrative areas were swabbed for SARS-CoV-2. The swabs were screened for the presence of viral RNA using a SARS-CoV-2 qPCR Probe Assay. Results: None of the 103 swabs reached a cycle threshold (cT) value ≤30 (strong viral presence, suggestive of potential surface transmission). Four samples showed cT values >30 and <35 (low quantity of virus) and 16 swabs returned a cT value ≥35 and <40 (inactive virus remnants). The remaining 83 samples were negative (cT value ≥40). Most samples with viral or viral remnant presence originated from high-touch areas. Conclusion: We did not find evidence for potential surface transmission in football club facilities when routine cleaning procedures are in place despite the presence of infected subjects.

Assessment of exposure risks to COVID-19 among frontline health care workers in Amhara Region, Ethiopia: A cross-sectional survey.

BackgroundThe burden to fight with Corona Virus Disease-19 (COVID-19) pandemic has lied to frontline health care workers that are putting themselves at a higher risk in the battle against the disease. This study aimed to assess the exposure health risks of COVID-19 among frontline healthcare workers in the Amhara region, Ethiopia.MethodA web-based cross-sectional study was conducted on public health workers from May to August 2020. Data were collected using a structured questionnaire via email and telegram services. Both descriptive statistics and bivariate followed by multivariable logistic regression analyses were conducted to identify distribution patterns and factors associated with exposure risks to COVID-19. Odds ratio with 95% Confidence Interval (CI), and a P-value of <0.05 was used to determine statistical significance.ResultA total of 418 health care workers participated in the study with a response rate of 99.1%. The majority of the study participants 310(74.2%), were males, and 163(39%) were nurses/ midwives respectively. More than half of the respondents 237(56.7%), had reported that they didn`t have face-to-face contact with a confirmed COVID-19 patient. Among the respondents, 173(41.4%), 147(35.2%), 63(15.1%), and 65(15.6%) of the health professionals had always used gloves, medical masks, face shield, or goggles/protective glasses, and disposable gown, respectively. In this study, age between 25–34 years (AOR = 0.20), age between 35–44 years (AOR = 0.13), family size of >6 (AOR = 3.77), work experience of 21–30 years (AOR = 0.01), and good handwashing habit (AOR = 0.44) were the protective factors against COVID-19. On the other hand, perception of non-exposure to COVD 19 (AOR = 9.56), and poor habit of decontamination of high touch areas (AOR = 2.52) were the risk factors associated with confirmed COVID 19 cases among health care workers.ConclusionPoor adherence to personal protective equipment use and aseptic practices during and after health care interactions with patients were identified. Strategies should be implemented to institute effective and sustainable infection control measures that protect the health care workers from COVID-19 infection.

820. Impact of pulsed xenon ultraviolet (PX-UV) light disinfection for reduction of pathogens on high touch surfaces following hospitalization

BackgroundUltraviolet (UV) light disinfection following a manual terminal cleaning process for hospital rooms has been proposed as an additional method to reduce the bacterial burden on surfaces. The impact of UV light disinfection and the level of interdependence between the modalities remains unclear.MethodsSamples were collected from 5 high touch surfaces from 10 patients room following discharge prior to manual disinfection, following manual disinfection, and following pulsed xenon UV disinfection using Rodac contact plates (total 150 samples). Colonies were identified using MALDI-TOF mass spectrometry. The bacterial colony counts were recorded and analyzed as pathogenic or commensal organisms (based on CDC criteria) to assess the efficacy of the disinfection process.ResultsAverage colony counts for the rooms prior to disinfection, post disinfection, and post UV light were 185.8 CFU +/- SD 280, 43 CFU +/- 121, and 20 CFU +/- 36.7 respectively. The average drop in colony-forming units of the five high touch areas in patient’s rooms can be seen in table 1. Twelve commensal bacterial species were isolated: Bacillus species (sp.), Corynebacterium sp., Enhydrobacter sp., Kocuria sp., Lysinibacillus sp., Macrococcus sp., Micrococcus sp., Paenibacillus sp., Pantoea sp., Psychrobacter sp., Siccibacter sp., Coagulase negative staphylococcus. Seven pathogenic bacteria were isolated: Acinetobacter sp., Brucella sp., Proteus sp., Staphylococcus aureus, Escherichia sp., Enterococcus, and Pseudomonas aeruginosa. Reductions in the predominant bacterial species following disinfection modality are noted in table 2.Table 1: Colony forming units (CFUs) average Pre-disinfection (Pre-Dis), Post Disinfection (Post-Dis), and Post PX-UV Light (PX-UV). Table 2: Sub-analysis of commensal and pathogen isolation Pre-Disinfection (Pre-Dis), Post-Disinfection (Post-Dis), and Post PX-UV light (PX-UV). ConclusionA combination of manual disinfection and UV has shown a notable additional reduction in overall bacterial contamination of the patient rooms, including the majority of high touch areas as compared with manual disinfection alone. No additional reduction in commensal bacteria isolates was noted after UV light, however a further decrease in pathogenic bacteria (Acinetobacter and Enterococcus) was noted. UV light may be considered as an additional room disinfection method to reduce overall bacterial burden and pathogenic bacterial contamination of rooms as a comprehensive strategy to reduce nosocomial infections.Disclosures Mark Stibich, n/a, Xenex Germ-Zapping Robots (Board Member, Grant/Research Support) Chetan Jinadatha, MD, MPH, AHRQ (Research Grant or Support)Department of Veterans Affairs (Other Financial or Material Support, Owner: Department of Veterans Affairs. Licensed to: Xenex Disinfection System, San Antonio, TX)Inventor (Other Financial or Material Support, Methods for organizing the disinfection of one or more items contaminated with biological agents)NiH/NINR (Research Grant or Support)NSF (Research Grant or Support)Xenex Healthcare Services (Research Grant or Support)

Antimicrobial coating is associated with significantly lower aerobic colony counts in high-touch areas in an orthopedic ward environment

BackgroundHospital acquired infections (HAI) are the most common complication found in the hospital environment. The aim of the study was to examine whether the use of an antimicrobial coating in high-touch areas in an orthopedic ward could reduce bacterial growth and HAI.MethodsFrom December 2017 to February 2018, HAI were registered on two orthopedic wards. A second registration was performed from December 2018 to February 2019. On the second occasion, an antimicrobial organosilane coating was applied just before the study period and thereafter weekly on one ward, while the other ward served as a control. Twenty defined high-touch areas on each ward were cultured before treatment and after 1, 2, 4, 8, 12, 14 and 16 weeks. Samples were cultured for aerobic colony counts, Staphylococcus aureus and E. coli.ResultsThe total aerobic colony counts were 47% lower on the treated ward compared with the non-treated ward over the study period (p = 0.02). The colony counts for Staphylococcus aureus and E. coli were low on both wards. During the first registration period, the incidence of HAI was 22.7% and 20.0% on the non-treated and subsequently treated ward respectively. On the second occasion, after treatment, the incidence was 25.0% and 12.5% (treated ward) respectively (p = 0.0001).ConclusionsThe use of a long-lasting antimicrobial organosilane coating appears to reduce the bioburden and reduce HAI. Since the incidence of HAI varies substantially over time, longer observation times are needed.

Protecting perioperative patients and personnel in the era of COVID-19.

Protecting perioperative patients and personnel in the era of COVID-19.

Environmental screening of multi drug resistant organisms in high touch area of critical and non critical units in tertiary care hospital

Patient’s environment in Health care settings responsible for causing variety of infections to patients and to the healthcare professions. Many of them are MDRO which may get transmitted as hospitals acquired infections that increases the chances of mortality and morbidity. These study was undertaken to isolate and identify aerobic bacteria with their resistance pattern in high touch areas of critical and non-critical care units of tertiary care hospital in absence of defined outbreaks.The cross sectional analytical study was carried out in the Microbiology Department, after obtaining the Institutional Ethics Committee clearance with waiver of consent during a period of two months. A total 100 samples from nine surface locations of critical and non critical care units of tertiary care hospital were included in this study. All tubes were vortexed and 0.5 μl of the peptone water was inoculated immediately on Blood Agar and MacConkey Agar for semi-quantitative estimation of the organisms.The environmental screening for MDROs from high touch areas was carried out in the 650 bedded tertiary care hospital.. A total of 34/126 (26.98%) samples from various areas had the growth of microorganisms where Staphylococcus aureus predominated. 24.60% showed S. aureus growth while 2.38% were E.coli. A total of 47.05% strains were isolated from the critical care areas all of which were S. aureus whereas 52.94% strains were from the non-critical areas. This study established to isolate and identify aerobic bacteria with their resistance pattern in high touch areas of critical and non critical care units of tertiary care hospital in absence of defined outbreak. These creates awareness regarding emerging of MDROs in hospital settings and also leads to improve in imperfect techniques of hand hygiene practices as well as inadequate surface disinfection practices especially in high touch areas.This study established the presence of aerobic bacteria with their resistance pattern in high touch areas of critical and non critical care units of tertiary care hospital in absence of defined outbreak. This will help creates awareness regarding emerging of MDROs in hospital settings and also leads to improve in imperfect techniques of hand hygiene practices as well as inadequate surface disinfection practices especially in high touch areas.

Longitudinal Characterization and Transmission Dynamics of Antibiotic-Resistant Organisms in an ICU (LOCATE AROs)

Background: Healthcare-associated infections caused by antibiotic-resistant organisms (AROs) are a major cause of significant morbidity and mortality. To create and optimize infection prevention strategies, it is crucial to delineate the role of the environment and clinical infections. Methods: Over a 14-month period, we collected environmental samples, patient feces, and patient bloodstream infection (BSI) isolates in a newly built bone marrow transplant (BMT) intensive care unit (ICU). Samples were collected from 13 high-touch areas in the patient room and 4 communal areas. Samples were collected from the old BMT ICU, in the new BMT ICU before patients moved in, and for 1 year after patients moved in. Selective microbiologic culture was used to isolate AROs, and whole-genome sequencing (WGS) was used to determine clonality. Antibiotic susceptibility testing was performed using Kirby-Bauer disk diffusion assays. Using linear mixed modeling, we compared ARO recovery across time and sample area. Results: AROs were collected and cultured from environmental samples, patient feces, and BSI isolates (Fig. 1a). AROs were found both before and after a patient entered the ICU (Fig. 1b). Sink drains had significantly more AROs recovered per sample than any other surface area (P &lt; .001) (Fig. 1c). The most common ARO isolates were Pseudomonas aeruginosa and Stenotrophomonas maltophila (Fig. 1d). The new BMT ICU had fewer AROs recovered per sample than the old BMT ICU (P &lt; .001) and no increase in AROs recovered over the first year of opening (P &gt; .05). Furthermore, there was no difference before versus after patients moved into the hospital (P &gt; .05). Antibiotic susceptibility testing reveal that P. aeruginosa isolates recovered from the old ICU were resistant to more antibiotics than isolates recovered from the new ICU (Fig. 2a). ANI and clonal analyses of P. aeruginosa revealed a large cluster of clonal isolates (34 of 76) (Fig. 2b). This clonal group included isolates found before patients moved into the BMT ICU and patient blood isolates. Furthermore, this clonal group was initially found in only 1 room in the BMT ICU, and over 26 weeks, it was found in sink drains in all 6 rooms sampled (Fig. 2b). Conclusions: AROs are present before patients move into a new BMT ICU, and sink drains act as a reservoir for AROs over time. Furthermore, sink-drain P. aeruginosa isolates are clonally related to isolates found in patient BSIs. Overall, these results provide insight into ARO transmission dynamics in the hospital environment.Funding: Research reported in this publication was supported by the Washington University Institute of Clinical and Translational Sciences grant UL1TR002345 from the National Center for Advancing Translational Sciences (NCATS) of the National Institutes of Health (NIH). The content is solely the responsibility of the authors and does not necessarily represent the official view of the NIH.Disclosures: None